Occupational contact with livestock is an established risk factor for exposure to livestock-associated methicillin-resistant Staphylococcus aureus (MRSA), particularly among industrial swine workers. While S. aureus is known to infect cattle, livestock-associated S. aureus carriage among workers in the beef production chain has received limited attention. Beefpacking workers, who slaughter, butcher and process cattle, have intensified exposure to potentially infectious animal materials and may be at risk of livestock-associated S. aureus exposure. We conducted a cross-sectional study of beefpacking workers (n = 137) at an industrial slaughterhouse in the Midwestern United States to evaluate prevalence and characteristics of S. aureus nasal colonization, specifically the absence of the scn gene to identify putative association with livestock, antibiotic susceptibility, presence of Panton-Valentin leukocidin (PVL) genes lukS-PV and lukF-PV, and spa type. Overall prevalence of S. aureus nasal carriage was 27.0%. No workers carried livestock-associated MRSA. Methicillin-sensitive S. aureus isolates (MSSA) recovered from five workers (3.6%) lacked the scn gene and were considered putative livestock-associated S. aureus (pLA-SA). Among pLA-SA isolates, spa types t338, t748, t1476 and t2379 were identified. To our knowledge, these spa types have not previously been identified as associated with livestock. Prevalence of human-adapted MRSA carriage in workers was 3.6%. MRSA isolates were identified as spa types t002, t008 and t024, and four of five MRSA isolates were PVL-positive. To date, this is the first study to indicate that industrial beefpacking workers in the United States may be exposed to livestock-associated S. aureus, notably MSSA, and to spa types not previously identified in livestock and livestock workers. Occupational exposure to livestock-associated S. aureus in the beef production chain requires further epidemiologic investigation.
BackgroundFinancial compensation of research participants has been standard practice for centuries, however, there is an ongoing debate among researchers and ethicists regarding the ethical nature of this practice. While these debates develop ethical arguments and theories, they fail to incorporate input from those most affected by financial compensation: potential research participants.MethodsTo identify attitudes surrounding clinical research, participants of a long-standing cohort completed a one-time interview. Open-ended questions stimulated a participant-driven discussion surrounding medical research. Following a grounded theory methodology, 58 semistructured interview transcripts were coded, focusing on attitudes surrounding financial compensation of research participants.ResultsOf the interviews coded, the majority of participants identified as Black/African American (n=44) and were women (n=40). Five major themes emerged. In support of financial compensation, participants felt that study participants should be compensated for time, effort and risk. However, participants were concerned that compensation may differentially impact low-income populations and entice them to hide potentially harmful side effects. Participants also mentioned that financial compensation may invalidate study results if participants knowingly provide false information to subvert inclusion/exclusion criteria.ConclusionThe emergence of both positive and negative themes reiterates the complicated issue of providing financial compensation for study participation. While compensation as a motivator for research participation raises ethical concerns, participants discussed weighing the benefits with the risks in order to make an informed decision. To avoid paternalistic behaviours, research staff must allow potential research participants to review the available information and make the decision that best reflects their wishes.
Background Connectedness and attachment are vital parts of humanity. Loneliness, a state of distress in reaction to perceived detachment and isolation, is reported by over one-third of U.S. adults and is associated with numerous physical and mental health consequences. What contributes to loneliness, especially in women and minority populations, is poorly understood, but this population is also at greater risk for abuse and trauma. Our study aimed to further understand loneliness in urban midlife women and to explore the relationship that may exist with trauma(s). Methods To identify primacies for mental health care, female midlife participants (N=50) of a long-standing urban community-based cohort focused on health improvement completed a one-time audiotaped interview with both quantitative assessments and a qualitative interview. Loneliness was assessed by the UCLA 3-item Loneliness Scale. Using semi-structured interviews, open-ended questions facilitated a discussion regarding mental health needs and experiences. Interview transcripts were coded and analyzed following a grounded theory methodology. Themes around loneliness and trauma emerged. The transcripts were coded using the same methodology and coders as the individual interviews. Twenty women participated in two optional focus groups. Results Participants had a mean age of 50, with the majority identifying as Black/African American (N=37) and unemployed (N=33). Three themes emerged regarding perceived causes of loneliness: trauma, the burden of responsibilities for others, and secondary to unhealthy relationships. Loneliness associated with trauma will be explored here; other themes are beyond the scope of this paper and will be discussed in subsequent analyses. Quantitative results suggest that physical abuse (loneliness scores 5.4 vs. 4.0, p=0.003), as well as emotional abuse and neglect (loneliness scores 5.6 vs. 4.4, p=0.01), were associated with greater loneliness. Conclusion In urban midlife low-income women, lifetime physical abuse and emotional abuse/neglect are associated with increased feelings of loneliness. Qualitative data provide insight into how participants viewed their traumatic histories, ways in which the trauma has ongoing influence, and how they experience loneliness. Though further investigation is needed, trauma-informed approaches should be considered in both primary care and mental health settings with a focus on mitigating loneliness and providing appropriate support and trauma treatment.
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